Apparatus and method for securing an oximeter probe to a patient

ABSTRACT

A strap or fastener for removably securing an oximeter probe to the appendage of a patient. The strap is made of an elastic material that wraps around the outside of the oximeter probe and is secured to the oximeter probe by attachment mechanisms such as Velcro that can be readjusted after initial application without producing excessive stress on the spring hinge of the oximeter probe.

This application is a continuation of U.S. patent application Ser. No.09/506,467, filed Feb. 17, 2000, now U.S. Pat. No. 6,385,821 which isherein incorporated by reference.

BACKGROUND OF THE INVENTION

The present invention relates to medical sensors for detectingphysiological functions and, in particular, to an apparatus for securingan oximeter probe to an appendage of a patient.

Pulse oximetry is a non-invasive medical technique useful for measuringcertain vascular conditions. A pulse oximetry system comprises a sensorappliance containing a light source, such as an L.E.D., and a lightsensor, such as a photodetector, and is mounted to the finger, toe orearlobe of a patient. The oximetry sensor emits light, which isscattered through a portion of the patient's tissue where blood perfusesthe tissue and the light sensor photoelectrically senses the absorptionof light in such tissue. The measurement of light absorbed is used toevaluate various characteristics of a patient such as oxygen saturationof hemoglobin in arterial blood, the volume of individual bloodpulsations supplying the tissue, and the rate of blood pulsationscorresponding to each heartbeat of a patient.

One kind of commonly used oximetry probe 110 is illustrated in FIGS. 1and 2. The probe 110 comprises first and second outer shells 112, 114, aspring hinge 116 at the distal end of the probe 110, first and secondextending tabs 118, 120, first and second inner pads 122, 124, and acord 128 connected to the proximal end of the probe. FIG. 1 depicts theoximeter probe 110 in use. The first and second outer shells 112, 114are separated by forcing the first and second extending tabs 118, 120toward one another. The patient's finger or other appendage is thenslipped between the first and second inner pads 122, 124. On the exposedfaces of the first and second inner pads 122, 124 are the photoemitterand photodetector used to measure various vascular conditions of thepatient. The data from the photodetector is then transmitted to anattached console electrical cord 128.

The spring hinge 116 is soft because excessive pressure on the fingercan distort pulsations in the finger's blood supply. As a result,oximetry sensors frequently fall off the patient's finger when thepatient is allowed to move unrestrained.

To prevent excessive movement of a finger to which the probe 110 isattached, medical personnel may secure the hand or arm to the patient'sbed or a stationary object located nearby. A patient would be allowed tomove the arm and hand more freely so that discomfort to the patient isavoided. To allow for the patient to move freely while not compromisingthe security of the oximeter probe 110 upon the finger, an additionalmeans of securing the probe 110 to the patient is necessary.

Further, even small movements by the patient can cause differentialmotion between the oximeter probe 110 and the patient because thephysical construction of the sensors renders them bulky and difficult tosecurely fasten to a patient's appendage. Such differential motioncauses the signal received by the light sensor to be distorted,resulting in inaccurate measurements of the amount of blood constituentbeing evaluated.

In practice, reusable oximeter probes are frequently secured to thepatient's appendage using adhesive tape. This method requires that theadhesive tape be applied such that sufficient pressure is applied to thepatient's finger to securely fasten the oximeter probe 110, but not somuch that vasoconstriction occurs. If the practitioner creates too muchor too little pressure during the initial application of the adhesivetape, it becomes necessary to remove the adhesive tape from the body ofthe oximeter probe 110 and replace it in a different position. Suchreadjustment is made difficult by the bond between the tape and theshell of the oximeter probe 110. In addition, the residual adhesiveremaining on the shell increases risk of contamination. Further, if thetape is in contact with both the patient's skin and the oximeter probe110, removal of the adhesive tape from the patient's skin can causeirritation, especially when the patient's skin is particularly sensitivedue to trauma or age.

Often, when adhesive tape is used to secure an oximeter probe to theappendage of the patient, the adhesive tape stresses the structure ofthe oximeter probe. Such distortion occurs if the adhesive tape is notapplied with substantially equal pressure on both side openings of theoximeter probe. The undue stress on the spring mechanism that resultsfrom such distortion shortens the useful life span of the oximeterprobe. Additionally, use of adhesive tape to secure the oximeter probeto the patient also decreases the useful life span of the oximeter probeby making sterilization of the oximeter probe after each use difficultbecause of adhesive build up. When adhesive tape is removed from theoximeter probe, residue of the adhesive remains on the shell of theprobe. Removing the residue may require vigorous scrubbing and/or use ofabrasive cleaning agents.

Another concern when securing an oximeter probe to a patient is ensuringthat ambient light does not interfere with the signal being received bythe photodetector. Outside light is easily scattered and transmittedwithin the tissue toward the photodetector because skin tissue istranslucent. This ambient light causes interference with the signaldetected at the photodetector.

Further, vasoconstriction may also be caused by exposure of theappendage to the often cool outside air. Low temperature inducedvasoconstriction and the resultant decrease in blood supply maysignificantly affect the performance of the oximeter probe. Conventionalattempts to alleviate the problem of low temperature vasoconstrictioninclude using an integral heater with the sensor and periodic massaging.Heaters, however, must be well regulated to avoid overheating.Furthermore, they increase the complexity of the sensor and can becostly. Periodic massaging can be effective, but usually requiresremoval of the probe while the appendage is massaged. After somemassaging of the appendage to stimulate blood flow to it, the probe isreapplied and measurement resumed. It would be desirable to employ aless complex, passive means for retaining body heat that does notinterrupt the measurement process.

SUMMARY OF THE INVENTION

The present invention is preferably a strap for securing an oximeterprobe to an appendage of a patient. The strap is preferably made ofelastic material and may be removably secured to the outside of anoximeter probe to allow for readjustment of the strap after initialapplication without producing excessive stress on the spring hinge ofthe oximeter probe.

In one embodiment, the strap is preferably a patch of materialcomprising a body, a tab located at a proximal end of the body andconnected to the body of the strap by a narrow neck, an attachmentmechanism for securing the body of the strap about an oximeter probe,and another attachment mechanism for securing the tab about the cord ofan oximeter probe. Preferably, at a distal end of the body of the strapis a flap that has a slit through which the extending flap of the topshell of the oximeter probe may be placed to prevent excessivelongitudinal movement of the strap.

In another embodiment of the present invention, the strap is preferablya patch of material comprising a body, a tab located at a proximal endof the body and connected to the body of the strap by a narrow neck, oneattachment mechanism for securing the body of the strap, a secondattachment mechanism for securing the tab and a third attachmentmechanism preferably substantially perpendicular to the first and secondattachment mechanisms for preventing excessive longitudinal movement ofthe strap.

In yet another embodiment of the strap, the strap preferably comprisestwo flaps connected by a neck, one of the flaps having a tab. The strapis secured to the oximeter probe by placing the flaps on opposing sidesof the oximeter probe and placing the neck along the spring hinge at thedistal end of the oximeter probe. An attachment mechanism is wrappedaround the strap enclosing the body of the oximeter probe to secure theprobe to an appendage of a patient while a second attachment mechanismis wrapped around the tab of the strap enclosing the cord neck of theoximeter probe to prevent excessive longitudinal movement of the strap.

In yet another embodiment of the present invention the strap ispreferably conformed as a sock which, in use, is slipped over theoximeter probe. The strap further comprises two attachment mechanisms.One attachment mechanism is wrapped around the strap about the body ofthe oximeter probe so that the spring hinge is appropriately compressedon the appendage of the patient. The other is wrapped around the strapenclosing the cord neck of the oximeter probe.

For a fuller understanding of the nature of the present invention,reference should be made to the ensuing detailed description taken inconjunction with the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

In the drawings:

FIG. 1 is a perspective view from the proximal end of an oximeter probe.

FIG. 2 is a perspective view from the distal end of an oximeter probe.

FIG. 3 is a perspective view of a preferred embodiment of the oximeterprobe strap according to the present invention.

FIG. 4 is a perspective view, from the proximal end of the oximeterprobe, of the strap depicted in FIG. 3 in use.

FIG. 5 is a perspective view of a second preferred embodiment of theoximeter probe strap according to the present invention.

FIG. 6 is a perspective view, from the proximal end of the oximeterprobe, of the strap depicted in FIG. 5 in use.

FIG. 7 is a perspective view, from the distal end of the oximeter probe,of the strap depicted in FIG. 5 in use.

FIG. 8 is a perspective view of a third preferred embodiment of theoximeter probe strap according to the present invention.

FIG. 9 is a perspective view, from the proximal end of the oximeterprobe, of the strap depicted in FIG. 8 in use.

FIG. 10 is a perspective view, from the distal end of the oximeterprobe, of the strap depicted in FIG. 8 in use.

FIG. 11 is a perspective view of a fourth preferred embodiment of theoximeter probe strap according to the present invention.

FIG. 12 is a perspective view, from the distal end of the oximeterprobe, of the strap depicted in FIG. 11 in use.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

FIGS. 1 and 2 illustrate a reusable oximeter probe 110 commonly used inthe medical industry. FIG. 1 is a perspective view taken from theproximal end of the oximeter probe 110 while attached to a patient. FIG.2 depicts the oximeter probe 110 from the distal end in its neutralposition.

The oximeter probe 110 comprises a first and second outer shell 112,114, a spring hinge 116 at the distal end of the probe, first and secondextending tabs 118, 120, first and second inner pads 122, 124, a cordsleeve 126, and a cord 128. FIG. 1 depicts the oximeter probe in use.The first and second outer shells 112, 114 are separated by pressing thefirst and second extending tabs 118, 120 toward one another. Thepatient's finger or other appendage is then slipped between the firstand second inner pads 122, 124. On the inside faces of the first andsecond inner pads 122, 124 are a photoemitter and a photodetector (notshown) used to measure various vascular conditions of the patient. Thedata from the photodetector is then transmitted to an attached consolevia the cord 128.

FIG. 3 is a perspective view of a preferred embodiment of an oximeterprobe strap comprising a body 202, a tab 206 located at the proximal endof the body 202, a first attachment mechanism 210 for securing the body202 of the strap 200, and a second attachment mechanism 214 for securingthe tab 206. The tab 206 is preferably connected to the body 202 of thestrap 200 by a preferably narrow strip 204, the body 202, tab 206, andstrip 204 preferably constituting a single patch of elastic material.

The strap may also include a flap 218 at the end opposing the strip 204,the flap 218 having a slit 216 through which the extending tab 118 ofthe top shell 112 of the oximeter probe 110 may be placed, as shown inFIG. 4. It is preferrable that the strap 200 include the flap 218 withthe slit 216 so that longitudinal movement of the strap 200 along thehard outer shells 112, 114 of the oximeter probe 110 may be minimized.

The strap 200 preferably has a total length (from proximal to distalend) of approximately 3.0 inches. The width of the body 202 preferablyis approximately 3.5 inches and the width of the tab 206 preferably isapproximately 1.25 inches. The body 202 and the tab 206 constitute onepatch of elastic material that is preferably composed of a foam laminatewith brushed nylon that is hook engagable.

As illustrated in FIG. 4, on a surface of the body 202 of the strap 200is the first attachment mechanism 210 for securing the strap 200 aboutthe oximeter probe 110 such that the spring hinge 116 of the oximeterprobe 110 is appropriately compressed to maintain secure contact betweenthe inner surfaces 122, 124 of the oximeter probe 110 and the appendageof the patient. The first attachment mechanism 210 preferably iscomprised of a patch of hook material, such as Velcro, which may beadhesively laminated 210 to the material of the strap 200 as shown inFIG. 3. Alternatively, the first attachment mechanism 210 may becomprised of adhesive strip or a patch of hook material separate fromthe strap 200.

On a surface of the tab 206 is a second attachment mechanism 214 forholding the strap 200 about the cord sleeve 126 of the oximeter probe110. Like the first attachment mechanism 210, the second attachmentmechanism 214 preferably comprises a patch of hook material, such asVelcro, which may be adhesively laminated 212 to the tab 206 as shown inFIG. 3. Alternatively, the second attachment mechanism 214 mayconstitute an adhesive strip or a patch of hook material separate fromthe strap 200.

In use, after the patient's appendage is secured in the probe 110, thebody 202 of the strap 200 may be placed over the top portion of the hardshell 112 of the oximeter probe 110 with the extending tab 118 of thetop portion of the hard shell placed through the slit 216 in the flap218 of the strap 200. The first attachment mechanism 210 may be wrappedaround the outer surface of the body 202 of the strap 200 enclosing theupper and lower hard shells 112, 114 of the oximeter probe 110. Thesecond attachment mechanism 214 may be wrapped around the tab 206,enclosing the cord sleeve 126 of the oximeter probe 110.

When hook material is used for the first and second attachmentmechanisms 210, 212, the attachment mechanisms can be secured directlyto the elastic material that constitutes the strap 200. When adhesivestrips are used for the attachment mechanisms 210, 212 the strips may beplaced around the entire circumference so that the opposing ends of theadhesive strips overlap to allow for a secure bond. Using hook materialas the attachment mechanism may be preferred over an adhesive stripbecause it may facilitate to a greater degree readjustment of the firstattachment mechanism 210 about the strap 200 and the oximeter probe 110.

The combination of the slit 216 in the body 202 of the strap 200 and thesecond attachment mechanism 214 wrapped around the tab 206 enclosing thecord sleeve 126 prevents excessive longitudinal movement of the strap200 along the hard shells 112, 114 of the oximeter probe 110. Likewise,the attachment mechanism 210 of the body 202 of the strap 200 holds theoximeter probe 110 securely to the appendage of the patient byreinforcing the spring action of the spring hinge 116.

FIGS. 5-7 illustrate an alternative preferred embodiment of an oximeterprobe strap. FIG. 5 is a perspective view of a strap 300 alone. FIG. 6depicts the strap 300 in use as viewed from the proximal end of theoximeter probe 110. FIG. 7 shows the strap 300 in use as viewed from thedistal end of the oximeter probe 110. As shown in FIG. 5, strap 300 isillustrated to have some of the same components as strap 200. Numberswith identical second and third digits represent correspondingcomponents.

The body 312 of the strap 300 preferably does not have a slit 216 asdoes the strap 200 depicted in FIG. 3. Instead, a third attachmentmechanism 318 is attached to the body 302 of the strap 300 such that itpreferably wraps around the distal end of the oximeter probe 110 and isattached to the opposite side of the body 302 of the strap 300 as shownin FIGS. 6-7.

The attachment mechanisms 310, 314, 318 are preferably comprised of apatch of hook material, such as Velcro, which may be adhesivelylaminated 308, 312, 316 to the material of the strap 300 as shown inFIG. 5. Alternatively, the attachment mechanisms 310, 314, 318 arecomprised of an adhesive strip or a patch of hook material separate fromthe strap 300.

Referring to FIGS. 6-7, the body 302 of the strap 300 is placed over thetop portion of the hard shell 112 of the oximeter probe 110. The firstattachment mechanism 310 may be wrapped around the outer surface of thebody 302 of the strap enclosing the upper and lower hard shells 112, 114of the oximeter probe 110. The second attachment mechanism 314 of thetab 306 may be wrapped around the tab 306, enclosing the cord sleeve 126of the oximeter probe 110. As illustrated in FIGS. 6-7, the thirdattachment mechanism 318 is attached 316 to the body 302 of the strap300, wrapped around the distal end of the oximeter probe 110 andattached to the body 302 of the strap 300 on the opposite side of theprobe 110.

The second attachment mechanism 314 may be placed around the tab 306enclosing the cord sleeve 126 and the third attachment mechanism 318 maybe placed around the distal end of the oximeter probe 110 to preventexcessive longitudinal movement of the strap 300 along the hard shells112, 114 of the oximeter probe 110. Likewise, the first attachmentmechanism 310 of the body 302 of the strap 300 holds the oximeter probesecurely to the appendage of the patient by reinforcing the springaction of the spring hinge 116.

Another preferred embodiment is shown in FIGS. 8-10. This embodiment ofthe oximeter probe strap 400 is comprised of a first flap 402A and asecond flap 402B, a tab 406, a connecting neck 418, a first attachmentmechanism 410 and a second attachment mechanism 414. The first flap 402Aand the second flap 402B are at opposite ends of the neck portion 418 ofthe strap 400. The first attachment mechanism 410 attaches to the firstflap 402A and the second attachment mechanism attaches to the tab 406.

In use, the first flap 402A of the strap 400 is placed along the side ofthe oximeter probe 110 where the upper and lower shells 112, 114 meet.The neck 418 of the strap 400 wraps around the distal end of theoximeter probe 110 and the second flap 402B is placed along the side ofthe oximeter probe 110 where the upper and lower shells 112, 114 meet,opposite the first flap 402A. The first attachment mechanism 410 iswrapped around the surface of the first and second flaps 402A, 402B,such that the spring hinge 116 of the oximeter probe 110 is secured inan appropriately compressed position. The second attachment mechanism414 is wrapped around the surface of the tab 406 enclosing the cordsleeve 126 of the oximeter probe 110.

The first and second attachment mechanisms 410, 414 preferably arecomprised of a patch of hook material, such as Velcro, which may beadhesively laminated 408, 412 to the material of the strap 400 as shownin FIG. 8. Alternatively, the first and second attachment mechanisms408, 412 are comprised of an adhesive strip or a patch of hook materialseparate from the strap 400. If an adhesive strip is used, it ispreferably wrapped completely around the surface of the strap 400 suchthat opposing ends of the adhesive strip overlap to ensure a securebond. The use of hook material for the first and second attachmentmechanisms 410, 414 is preferred to facilitate readjustment of theattachment mechanisms 410, 414.

Another preferred embodiment is shown in FIGS. 11-12. This embodiment ofthe oximeter probe strap 500 is preferably comprised of at least onepatch of fabric 502 in a sock-like apparatus with an opening 530, afirst attachment mechanism 510 and a second attachment mechanism 514.

FIG. 12 depicts the strap 500 in use. The strap 500 may be slid over theoximeter probe 110 such that the body of the probe enclosing thepatient's appendage is inside the fabric 502 and the cord 128 exits thestrap 500 through the strap opening 530. The first attachment mechanism510 may be wrapped around the surface of the fabric 502 as a girthenclosing the first and second outer shells 112, 114, the spring hinge116 and the first and second extending tabs 118, 120 of the oximeterprobe strap 110 such that the spring hinge 116 of the oximeter probe 110is secured in an appropriately compressed position about the patient'sappendage. The second attachment mechanism 514 is wrapped around thefabric 502 enclosing the cord sleeve 126 of the oximeter probe 110.

The first and second attachment mechanisms 510, 514 preferably arecomprised of a patch of hook material, such as Velcro, which may beadhesively laminated 508, 512 to the material of the strap 502 as shownin FIG. 11. Alternatively, the first and second attachment mechanisms508, 512 are comprised of an adhesive strip or a patch of hook materialseparate from the strap 500. If an adhesive strip is used, it ispreferably wrapped completely around the surface of the strap 500 suchthat opposing ends of the adhesive strip overlap to ensure a securebond. The use of hook material for the first and second attachmentmechanisms 510, 514 is preferred to facilitate readjustment of theattachment mechanisms 510, 514.

As will be understood by those skilled in the art, the present inventionmay be embodied in other specific forms without departing from theessential characteristics thereof. Accordingly, the foregoingdescription is illustrative of the invention, but not limiting to thescope of the invention, which is set forth in the following claims.

What is claimed is:
 1. A strap for an oximeter probe, comprising: apatch having a first flap, a second flap, an elongated neck joining saidfirst flap and said second flap, and a tab connected to said secondflap; a first attachment mechanism for removably securing said first andsecond flaps to outer shells of the oximeter probe; and a secondattachment mechanism for removably securing said tab to a cord of theoximeter probe.
 2. The strap of claim 1 wherein said first attachmentmechanism is substantially perpendicular to said neck.
 3. The strap ofclaim 1 wherein said first attachment mechanism is substantiallyparallel to said second attachment mechanism.
 4. A strap for an oximeterprobe, comprising: a patch having a first flap, a second flap, a neckjoining said first flap and said second flap, and a tab connected tosaid second flap; a first attachment mechanism for removably securingsaid first and second flaps to outer shells of the oximeter probe; and asecond attachment mechanism for removably securing said tab to a cord ofthe oximeter probe; wherein said patch comprises an elastic hookengagable material.
 5. The strap of claim 4, said elastic hook engagablematerial comprising foam laminate with a brushed nylon surface.
 6. Astrap for an oximeter probe, comprising: a patch having a first flap, asecond flap, a neck joining said first flap and said second flap, and atab connected to said second flap; a first attachment mechanism forremovably securing said first and second flaps to outer shells of theoximeter probe; and a second attachment mechanism for removably securingsaid tab to a cord of the oximeter probe; wherein said flaps areapproximately 1.5 inches square and said neck is approximately 1.5inches in length.
 7. The strap of claim 1 wherein said first and secondattachment mechanisms are comprised of hook material.
 8. A strap for anoximeter probe, comprising: a patch having a first flap, a second flap,a neck joining said first flap and said second flap, and a tab connectedto said second flap; a first attachment mechanism for removably securingsaid first and second flaps to outer shells of the oximeter probe; and asecond attachment mechanism for removably securing said tab to a cord ofthe oximeter probe; wherein said first and second attachment mechanismsare comprised of hook material, and at least one of the attachmentmechanisms is adhesively laminated to said patch.
 9. A strap for anoximeter probe, comprising: a patch having a first flap, a second flap,a neck joining said first flap and said second flap, and a tab connectedto said second flap; a first attachment mechanism for removably securingsaid first and second flaps to outer shells of the oximeter probe; and asecond attachment mechanism for removably securing said tab to a cord ofthe oximeter probe; wherein said first and second attachment mechanismsare adhesive strips.
 10. A strap for an oximeter probe, comprising: apatch having a first flap, a second flap, a neck joining said first flapand said second flap, and a tab connected to said second flap; a firstattachment mechanism for removably securing said first and second flapsto outer shells of the oximeter probe; and a second attachment mechanismfor removably securing said tab to a cord of the oximeter probe; whereinsaid tab extends substantially parallel to said neck.
 11. The strap ofclaim 1 wherein said second attachment mechanism is substantiallyperpendicular to said neck.
 12. A strap for an oximeter probe,comprising: a patch having a first flap, a second flap, a neck joiningsaid first flap and said second flap, and a tab connected to said secondflap; a first attachment mechanism for removably securing said first andsecond flaps to outer shells of the oximeter probe; and a secondattachment mechanism for removably securing said tab to a cord of theoximeter probe; wherein said cord is disposed on a proximal end of theoximeter probe and said neck is sized to wrap around a distal end of theoximeter probe.
 13. A strap for an oximeter probe, comprising: a patchhaving a first flap sized to be removably secured to a first portion ofan oximeter probe, a second flap sized to be removably secured to asecond portion of an oximeter probe, and a neck joining said first flapand said second flap, said neck sized to wrap around a distal end of theoximeter probe; and a first attachment mechanism for removably securingsaid first and second flaps to first and second portions of the oximeterprobe.
 14. The strap of claim 13 wherein said first and second portionsof the oximeter probe overlap.
 15. The strap of claim 13 furthercomprising a tab connected to one of said first and second flaps and asecond attachment mechanism for removably securing said tab to a cord ona proximal end of the oximeter probe.
 16. A strap for an oximeter probe,comprising: a patch having a first flap sized to be removably secured toa first portion of an oximeter probe, a second flap sized to beremovably secured to a second portion of an oximeter probe, and a neckjoining said first flap and said second flap, said neck sized to wraparound a distal end of the oximeter probe; a first attachment mechanismfor removably securing said first and second flaps to first and secondportions of the oximeter probe; and a tab connected to one of said firstand second flaps and a second attachment mechanism for removablysecuring said tab to a cord on a proximal end of the oximeter probe;wherein said tab extending substantially parallel to said neck.
 17. Astrap for an oximeter probe, comprising: a patch having a first flapsized to be removably secured to a first portion of an oximeter probe, asecond flap sized to be removably secured to a second portion of anoximeter probe, and a neck joining said first flap and said second flap,said neck sized to wrap around a distal end of the oximeter probe; and afirst attachment mechanism for removably securing said first and secondflaps to first and second portions of the oximeter probe; wherein thefirst and second flaps comprise an elastic hook engagable material. 18.The strap of claim 17 wherein the elastic hook engagable materialcomprises foam laminate with a brushed nylon surface.
 19. The strap ofclaim 13 wherein one of said the first and second attachment mechanismcomprises hook material.
 20. The strap of claim 1 wherein said first andsecond flaps are approximately the same size.
 21. The strap of claim 1wherein said neck has a length that is approximately the magnitude of asurface area of said first flap.
 22. The strap of claim 13 wherein saidfirst and second flaps are approximately the same size.
 23. The strap ofclaim 13 wherein said neck has a length that is approximately themagnitude of a surface area of said first flap.
 24. The strap of claim13 wherein said first flap is approximately 1.5 inches square and saidneck is approximately 1.5 inches in length.